Nose Conditions

Question 1

what conditions are assocciated with nasal polyps

Answer 1

allergic and non-allergic rhinitis, non-allergic asthma, aspirin allergy, CF

Question 2

what is the presentation of a nasal polyp

Answer 2

congested, discharge, sneezing, snoring, not painful

Question 3

what is the management of a nasal polyp

Answer 3

TOP CCS betamethasone, if fails surgical removal ESS

Question 4

what benign lesion can affect the nasal vestibule

Answer 4

squamous papilloma

Question 5

what is the commonest malignant lesion of the nose

Answer 5

nasopharyngeal carcinoma

Question 6

what type of cancer is nasopharyngeal carcinoma

Answer 6

squamous cell carcinoma

Question 7

what are risk factors for nasopharyngeal carcinoma

Answer 7

epstein barr virus infection

Question 8

how is EBV linked to malignancy

Answer 8

subclinical infection, infects epithelial cells (NPC) & B cells (lymphomas)

Question 9

what must be done on examination of a suspected nasal fracture

Answer 9

look up nose to check fro boggy septal haematoma

Question 10

how is a nasal fracture diagnosed

Answer 10

clinically; deviation/ cosmesis. no XR

Question 11

what is the management of a nasal fracture

Answer 11

nothing/MUA

review at ENT clinic 1wk later

Question 12

what are complications of a nasal fracture

Answer 12

epistaxis
CSF leak
meningitis
anosmia

Question 13

what is the management of epistaxis in a nasal fracture

Answer 13

pressure, vasoconstrictor, adrenaline, co-phenylcaine

Question 14

what vessel is most likely to be causing epistaxis in a nasal fracture

Answer 14

anterior ethmoidal

Question 15

what is battle sign

Answer 15

bruising behind ear in temporal bone fracture

Question 16

how are temporal bone fractures classified

Answer 16

if spare or involve the otic capsule

Question 17

are longitudinal or transverse temporal bone fractures more common

Answer 17

longitudinal

Question 18

what are complications of temporal bone fractures

Answer 18

ossicle disruption, CHL, SNHL, VII palsy, CSF leak

Question 19

where is a le fort 1 fracture

Answer 19

horizontal above teeth

Question 20

where is a le fort 2 fracture

Answer 20

pyramidal, through nasal bridge, maxilla frontal process, lacrimal, inferior orbital floor, zygoma, pterygomaxillary fissure, pterygoid plates

Question 21

where is a le fort 3 fracture

Answer 21

transverse, craniofacial disjunction

Question 22

what is the risk in cribriform plate fracture in le fort 2 and 3

Answer 22

infection spreads form nose/sinus to cranium

Question 23

investigations of facial trauma (suspected fracture)

Answer 23

CT and C spine XR

Question 24

what is the cause of acute sinusitis

Answer 24

nasopharynx organism spread to sinus

Question 25

which sinus is most commonly affected by sinusitis and why

Answer 25

maxillary since drains against gravity

Question 26

why are the cold and smoking risk factors for sinusitis

Answer 26

affect cilia (their job is to waft mucus towards ostia)

Question 27

what are the common infecting organisms in acute sinusitis

Answer 27

98% viral URTI | secondary bacterial infection: s. pneumoniae, h. influenzae, s. pyogenes, Moraxella

Question 28

what is the presentation of acute sinusitis

Answer 28

runny nose, discomfort on frontal/maxillary sinuses, tooth pain

Question 29

why can acute sinusitis present with tooth pain

Answer 29

referred pain from CNV1/2 shared sensory supply

Question 30

how is acute sinusitis diagnosed

Answer 30

clinical Dx

Question 31

what is the general management of acute sinusitis

Answer 31

nasal decongestant, analgesia

Question 32

when are antibiotics indicated for acute sinusitis

Answer 32

if persists longer than 10 days

Question 33

which antibiotics can be used for acute sinusitis

Answer 33

1st penicillin, 2nd doxycycline (not in child)

Question 34

what is a complication of ethmoidal sinusits

Answer 34

orbital cellulitis

Question 35

what is vasomotor rhinits

Answer 35

non-allergic

Question 36

what allergic tests are useful for allergic rhinitis

Answer 36

serum IgE, mast cells, skin prick

Question 37

what is the classification of allergic rhinits

Answer 37

intermittent or persistent

Question 38

what is intermittent rhinitis

Answer 38

symptoms <4day/wk or for <4wk

Question 39

what is persistent rhinitis

Answer 39

symptom >4day/wk + >4wk duration

Question 40

what is the management of allergic rhinitis

Answer 40

avoid allergen + antihistamine TOP CCS TOP CCS + antihistamine IgE immunotherapy